Fracture and orthopedic operating frame



E M A R F G N I M. mm P so N Ew HD E PP EO H TM so Aw A E R U T C A R F Jan.. 14, 1936..

4 Sheets-Sheet l ATTORNEYS Jam, X4, 19

A. STEPHENSON FRACIY'URE AND ORTHOPEDIG OPERATING FRAME Filed Jan. 13, 1934 4 Sheets-Sheet 2 IINVENTOR ATTORNEYSl Jan., M, 1 I A. srvEPH'ENsoN U79 FRACTURE AND ORTHOPEDIC OPERATING FRAME Filed Jan. l5, 1934 4 Sheets-Sheet 5 ATTORNEY-Y Jan.. M, 193., A. sTEPHENsoN FRACTURE AND ORTHOPEDIC OPERATING FRAME Filed Jan. l5, 1954 4 Sheets-Sheet 4 ATTORNEYS Patented Jan. 14, 1936 UNHE STABS FRACTURE AND OETHEEDIC OPERATENG FRAME Albert Stephenson, New `lf'ork, N. Y., assignor of one-half to Herbert M. Bergamini, New York,

This invention relates to a fracture and orthopedic operating frame. It is particularly concerned with an apparatus of the above mentioned character which has for its object the support of a patient in a xed position for operation for reduction and manipulation of skeletal injuries, such as fractures or dislocations.

A feature of the present invention is that it eliminates the necessity of lifting the patient from a stretcher or stretcher cart onto the operating apparatus or table.

It is a further feature of the present invention that the patient is supported from abo've so that the space below the patient is free of obstiuctions so that X-ray apparatus for either X- ray pictures or fluoroscopic examination of the injured part may be conveniently used while the patient is in position on the operating apparatus.

It is a further feature of the invention that it permits of the accessibility of the patient for the application of plaster casings, moldedaplaster splints or plaster casts for retention of the reduced deformity. The apparatus of the present invention, moreover, permits of the application of exact mechanical traction tol displaced or overriding fractures.

Various other features and objects of the invention will be readily understood from the following description having reference to' the accompanying drawings, in which:

Figure 1 is a side elevation of a preferred form of apparatus embodying my invention,

Figure 2 is an end view of the apparatus of Figure 1.

Figure 3 is a to-p plan view thereof.

Figure 4 is a view showing part of Figure 1 in section, the section being taken along line 4 4 of Fig. 1 looking in the direction of the arrows.

Figure 5 is a detail View of a portion of Figure 3, being a section thereof'on the line 5 5 looking in the direction of the arrows,

Figure 6 is a detail view of a portion of the mechanism of Figure 2, being a section thereof taken on the line 3 3 looking in the direction of the arrows, and

Figure 7 is a detail View of a portion of the mechanism of Figure a, being a section thereof taken along the line 1 1 looking in the direction of the arrows.

Similar characters of reference designate similar parts in each of the several views.

In Figures 1, 2 and 3, reference characters I, 2 and 3, designate uprights forming part of the frame. Upright I isrprovided with a base 8, which base is preferably provided with casters (not shown) to facilitate the movement of the frame to any desired location. For similar reasons, uprights 3 are provided with casters 9. Upright I is preferably in the form of a tube or pipe provided adjacent its upper end with a cas- I ing It] in which is mounted certain mechanism hereinafter explained. Upright I is rigidly connected to uprights 2 and 3 by means of pipes II and I2 which constitute a trackway for a carriage I3, referred to hereinafter. Pipes II and I2 are rigidly secured at one end to casing I in any suitable manner, as by clamps I4. At their other end they are iixed to a horizontal cross-bar I5, which is preferably hollow and adjacent its ends is supported by uprights 2 and 3.

Carriage I3 serves as a support for a sacral rest I6, this support being effected by means of a perineal bar I1 which extends upwardly from the rest. Bar I'I is threaded adjacent its upper end to cooperate with a nut I8 (Fig. 5) having a iiange which rests c'n the bottom I9 of carriage i3. Nut I8 may be rotated in one direction or the other by means of a hand wheel 23 mounted on a sleeve 2I which is keyed to nut I8, as shown at 22. Perineal bar I'I is prevented from following the rotation of nut I8 by means of keys I'Ia fixed in a head Ita of carriage I3, and arranged to cooperate with keyways I'Io on bar Il. Rest I6, it will thus be observed, may be raised or lowered with reference to carriage I3 by rotation of hand wheel 20 in one direction or the other.

Carriage I3 is mounted to slide on the trackway formed by pipes I I and I2 and mechanism is provided whereby this sliding movement may be effected mechanically. For this purpose carriage I3 is provided with a pair of dogs 23 fixed to the upper wall 24 of the carriage and provided with threaded sleeves 25, which cooperate with a pair of screws 23. These screws may be rotated in unison by means of a hand wheel 21 mounted on upright I. Wheel 2i communicates by bevelled gearing 23, stub shaft 29, bevelled gearing 33 and stub shaft 3 I, with a spur gear 32 mounted on the side of casing I!) (see Figures 2 and 3). Gear 32 serves to rotate gears 33 and 36 keyed to screws 26. Rotation of the hand wheel 2l thus brings about rotation of screws 23 in like -direction with reference to each other. This rotation is communicated by means of dogs 23 to carriage I3, so that this carriage is propelled in one direction or the other along the trackway formed by pipes I I and I2, depending upon the direction of rotation of hand wheel 21. My invention thus provides a mechanism whereby the sacral rest I6 may be adjusted to any desired position in a vertical plane, by the mere rotation of hand wheels 20 and 21 in the appropriate directions.

The operating frame of the present invention is provided also with foot supports 35 and 36. These supports are mounted on upright I by means of a clamp 31 and are made vertically adjustable by means of a pair of vertical slides 38 and 3S. As shown in Figure 6, a ratchet bar 4l] is provided in each slide, the teeth of which cooperate with a latch mechanism 4I. A spring 42 serves to hold the pawl 43 of the latch in operative engagement with the teeth of the ratchet bar. Each ratchet bar 40 may thus be adjusted in vertical position and is held in such adjusted position by means of latch mechanism 4I. Hollow members 44 are mounted in ratchet bars 4U so as to extend outwardly from upright I. Slides 38 and 39 are provided with longitudinal openings 45, Figure 4, to permit of the vertical movements of the ends of members 44 in the slides. The manner in which the members 44 .are mounted in ratchet bars 4B is indicated in Figure 4. It will be observed that in the illustrated construction the ends of members 44 are provided with an extension 4E of reduced diameter, which extension is forced into the metal 41 of the ratchet bars 40. Slidably mounted on each member 44 is a carriage 48. The position of this carriage on member 44 is governed by a hand wheel 4S, which serves to rotate a screw provided to cooperate with a threaded portion 5I of carriage 48. The left end of screw 5G is journaled in a bearing formed by the reduced end 46 of member 44. A pin 52 cooperating with a notch 53 in screw 5G serves to hold the end of screw 50 in place without interfering with the rotation thereof. It will here be observed that the hollow members 44 are provided with a slit 54 (see Figure '1 which slit cooperates with the flange 43a of carriage 48 to hold the said carriage in upright position. Adjacent its upper end each carriage 48 is provided with a socket 55 formed between a top plate 48b and the ange 48'3 of carriage 48. This socket is adapted to receive the ball 56 of a foot holder 51, a screw Ille having an operating knob IUI (Figures l and 7) being provided for engaging against and holding the ball in adjusted position. The foot holder may be of conventional character. In the embodiment illustrated, this holder consists of a bracket 58 mounted on ball 56 and provided with a horizontal slide 59 to which the foot supporting plate 60 is attached. Slide 59 may be propelled in one direction or the other with reference to bracket 53 by means of a screw 6I cooperating with a xed portion 62 of bracket 53.

In using the operating frame of the present invention for the reduction and manipulation of skeletal injuries, such asfractures or dislocations of the lower extremities, the patient is placed in position for the operation by rolling the stretcher cart on which he lies directly under the operating frame. 'Ihe sacral rest is then lowered by means of hand wheel 2D and moved longitudinally of the frame by means of hand wheel 21 until it is in proper position to support the patient at his hips. Depending upon the character of the fracture or dislocation, the feet of the patient are secured in the foot holders 51. The patient is thus supported in the frame of this invention both at his hips and feet. It will be noted that the supporting of the patient in the operating frame has been accomplished without the necessity of lifting the patient from the stretcher onto an operating table, as is now common practice. The

vstretcher cart may now be removed from under the lower extremities of the patient to a position such as shown by the dotted outline 10, and the patient may rest his head and shoulders on the stretcher cart. The lower extremities of the patient are thus rendered accessible f or X-ray apparatus or fluoroscopic examination of the injured parts. Exact mechanical traction may be applied to displaced or overriding fractures by proper manipulation of the foot rests 51 and the screws 6I thereof. The lower extremities of the patient are fully accessible for the application of plaster casings, molded plaster splints or plaster casts for the retention of the reduced deformity. After the operation is completed the stretcher cart is again placed in position to support the full length of the patient, the foot supports are removed from his feet and the sacral rest is re- `moved from under his thighs, by manipulation of hand wheels 20 and 21. Avlifting of the patient from an operating table to the stretcher is thus made unnecessary.

While the above description of the use of the frame of this invention has particular reference to the reduction and manipulation of fractures and dislocations of the lower extremities, it will be obvious to any one skilled in the art that the frame may be used in very similar manner for fractures or dislocations of the upper extremities, the foot supports in such instance being used for holding the patients hands, and the sacral rest I6 being used to support the patient's shoulders.

The frame of the present invention is capable also of use in connection with orthopedic operations. For such operations, the sacral rest I6 is elevated by hand wheel 20 until it is wholly out of the way, and the patient is supported in the frame by means of a stretcher, such as indicated at 63. The ends of this stretcher are hung from the frame by means of ropes 64 and 65, the latter of which passes over pulley 61 and the former of which passes over pulleys 36 and 61, both of which pulleys are supported in any suitable manner, as shown in Figure 1, adjacent the upper ends of the frame work. The terminals of ropes E4 and 65 are connected to carriage I3, so that, as the carriage moves, both ends of the hammock 63 are raised or lowered depending upon the direction of movement of carriage I3.

It will thus be observed that by simply manipuv lating the hand wheel 21, the hammock may be raised or lowered to the desired height for the operation. In the use of this apparatus for orthopedic operations, the patient is wheeled into position under the operating frame on the stretcher cart, the hammock 63 having previously been placed under the patient. The ends of the hammock are attached to ropes 64 and 65 by means of the detachable clips and the hand wheel 21 is then rotated until the patient is at the proper height for the operation and clear of the stretcher cart. This cart is then pulled out from under the patient. The patient is thus accessible, as previously described for X-ray apparatus and for the application of plaster casings or the like.

I have described what I believe to be the best embodiments of my invention. I do not, however, wish to be confined to the embodiments shown, but what I desire to cover by Letters Patent is set forth in the appended claims.

I claim:

1. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in desired position with reference to each other, said means comprising a frame, meansior supporting said members on said frame, said frame comprising a single upright at one end, a pair of uprights at the other end and a horizontal portion connecting said uprights and extending over said sacral rest, and means for supporting said sacral rest from said portion, said means comprising a perineal bar extending upwardly from said rest and carried by said portion.

2. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, said frame comprising a single upright at one end, a pair oi uprights at the other end and a horizontal track connecting said uprights and extending over said sacral rest, means for supporting said members on said frame, said `means comprising a pair of members extending horizontally from said single upright, a carriage on said track and a perineal bar extending vertically from said rest and supported by said carriage for Vsupporting said rest from said track.

3. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically irom said rest and supported from the carriage for supporting said rest from said carriage and means for adjusting the distance of said rest from said carriage, said means cornprising a nut supported in said carriage and free to turn with reference thereto, said perineal bar having a threaded portion for cooperating with said nut, a hand wheel for rotating said nut, and means on said carriage for preventing said bar from following the rotation of said nut.

4. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically from said rest and supported from the carriage for supporting said sacral rest from said carriage and means for propelling the carriage along said track, said means comprising a pair of horizontal screws, a hand wheel, means for rotating said screws in unison by said hand wheel and threaded members in said carriage and cooperating with said screws for propelling said carriage in response to rotation of said screws.

5. In combination, a sacral rest, extremity supporting members and .means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically from said rest and supported by the carriage for supporting said rest from said carriage, means for propelling the carriage along said track, said means comprising a nut supported in said carriage and free to turn with reference thereto, said perineal bar having a threaded portion for cooperating with said nut, a hand wheel for rotating said nut, and means Aon Vsaid carp riage for preventing said bar from following the rotation or said nut, and means for adjusting the distance of said rest from said carriage, said means comprising a pair of horizontal screws, a hand wheel, means for rotating said screws in unison by said hand wheel and threaded members on said carriage and cooperating with said screws `for propelling said carriage in response to rotation of said screws.

G. `In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in desired position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a portion extending over said sacral rest, and means for supporting said sacral rest from said portion, said means comprising a perineal bar extending upwardly from said rest and supported from said portion and means for propelling said extremity supporting members with reference to said rest, said` means comprising for each extremity supporting member, a slide on which said member is mounted, a threaded member for propelling said extremity supporting member in said slide, and screw threaded propelling means for said slide.

r1. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically from said rest and supported by said carriage for supporting said rest from said carriage, and means for propelling said extremity supporting members with reference to said rest, said means comprising for each extremity supporting member, a slide on which said member is mounted, a threaded member for propelling said extremity supporting member in said slide, and screw threaded propelling means for said slide.

8. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically from said rest and supported by said carriage for supporting said rest from said car-- riage, means for adjusting the distance of said rest from said carriage, and means for propelling said extremity supporting members with reference to said rest, said means comprising for each extremity supporting member, a slide on which said member is mounted, a threaded member for propelling said extremity supporting member in said slide, and screw threaded propelling means for said slide.

9. In combination, a sacral rest, extremity supporting members and means whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically from said rest and supported by said carriage for supporting said sacral Yrest from said carriage, means for propelling the carriage along said track and means for propelling said extremity supporting members with reference to said rest, said means comprising for each extremity supporting member, a slide on which said member is mounted, a threaded member for propelling said extremity supporting member in said slide, and screw threaded propelling means for said slide.

10. In combination, a sacral rest, extremity supporting members and lmeans whereby said rest and members are supported in adjustable position with reference to each other, said means comprising a frame, means for supporting said members on said frame, said frame comprising a. track extending over said sacral rest, a carriage on said track and a perineal bar extending vertically from said rest and supported by said carriage for supporting said rest from said carriage, means for propelling the carriage along said track, means for adjusting the distance of said rest from said carriage and means for propelling said extremity supporting members with reference to said rest, said means comprising for each extremity supporting member, a slide on which said member is mounted, a threaded member for propelling said extremity supporting member in said slide, and screw threaded propelling means for said slide.

11. An operating frame, comprising a single upright at one end, a pair of uprights at the other end, means comprising a trackway for connecting said uprights, a carriage for said track- Way, means for propelling said carriage on said trackway, and patient supporting means connected to said carriage, said means comprising a sacral rest and a perineal bar extending upwardly from said rest and supported from said carriage.

12. An operating frame, comprising an upright at one end, a pair of uprights at the other end, means comprising a trackway for connecting said uprights, a carriage for said trackway, a sacral rest, a perineal bar extending upwardly from said rest and supported from said carriage, means for propelling said carriage on said trackway, said means comprising a pair of parallel screws, threaded connections between said screws and said carriage, a handwheel, and mechanism for operatively associating said handwheel with said screws.

ALBERT STEPHENSON. 

